Buğday Duyarlılığı Saptanan Çocuk Hastaların Klinik Özelliklerinin Değerlendirilmesi

Abstract

Amaç: Bu çalışma ile merkezimizde deri prick testi (DPT) ile buğday atopisi saptanan çocuk hastalar içinde gerçek buğday alerjisi sıklığının belirlenmesi, hastaların klinik özelliklerinin ve prognozlarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Bu çalışma hastanemiz Çocuk Alerji ve İmmünoloji Kliniği’nde Ocak 2017 ile Mayıs 2023 tarihleri arasında deri prick test (DPT)’ lerinde buğday atopisi saptanan 63 hasta ile yapılmıştır. Bu hastaların demografik ve klinik özellikleri, oral provokasyon testleri (OPT) ve prognozları incelenmiştir. Bulgular: Yapılan 9432 besin DPT’nde 63 hastada buğday pozitifliği saptandı ve buğday atopi oranı %0.6 olarak bulundu. Bu hastaların %61.9’u kızdı. Buğday atopisi saptanan hastaların %55.5’i 0-6 ay arasındaki süt çocuklarından oluşmaktaydı. Altmış üç hastandan altı (%9.5)’i IgE aracılıklı reaksiyon düşündüren öykü ile, 57 (%90.5)’i ise atopikdermatit düşündüren öykü ile başvurmuştu. Atopik dermatit öyküsü olan bu hastalardan 34 (%59.6)’sında buğday atopisine ek olarak inek sütü ve yumurta atopisi de saptandı. İki ile dört haftalık kısa eliminasyondan sonra yapılan OPT’ de üç hastada egzama alevlenmesi görüldü. Bu hastalar 6-12 aylık eliminasyon diyeti sonrasında buğdayı sorunsuz bir şekilde tüketebildi. Sonuç: Oral provokasyon testleri ile doğrulanmayan buğday atopisi, temel besin maddesi olan buğdayın gereksiz eliminasyonuna neden olmaktadır. Bu durum buğday atopisi olan hastalarda OPT’nin önemini göstermektedir.

Keywords

• Oral provokasyon
• Buğday
• Duyarlılık

Evaluation of Clinical Features of Pediatric Patients with Wheat Sensitivity

Abstract

Objective: This study aimed to determine the frequency of true wheat allergy among pediatric patients with wheat sensitivity detected by skin prick test (SPT) in our center and to evaluate the clinical features and prognosis of the patients. Material and Methods: This study was conducted with 63 patients who were found to have wheat sensitivity on skin prick test (SPT) between January 2017 and May 2023 in the Pediatric Allergy and Immunology Clinic of our hospital.Demographic and clinical characteristics, oral provocation tests (OPT) and prognosis of these patients were analyzed. Results: In 9432 food SPTs, wheat positivity was detected in 63 patients and the wheat sensitivity rate was found to be 0.6%. Sixty-one point nine percent of these patients were girls. In patients with wheat atopy, 55.5% were infants between 0-6 months of age. Out of 63 patients, six (9.5%) presented with a history suggestive of IgE-mediated reaction, while 57 (90.5%) presented with a history suggestive of atopic dermatitis. Among these patients with a history of atopic dermatitis, 34 (59.6%) were found to have cow’s milk and egg atopy in addition to wheat sensitivity. Eczema exacerbation was observed in three patients on OPT performed after 2-4 weeks of short term elimination. These patients were able to consume wheat without any reaction after 6-12 months of elimination diet. Conclusion: Wheat sensitivity not confirmed by oral provocation tests leads to unnecessary elimination of wheat, an essential nutrient. This shows the importance of OPT in patients with wheat atopy.

Keywords

• Oral provocation Test
• Wheat
• Sensitivity

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